Neurologic disorder

1. SALALE UNIVERSITY COLLEGE OF HEALTH SCIENCE
DEPARTMENT OF ADULT HEALTH NURSING ,MATERNITY
AND PEDIATRICS
.
PATHOPHYSIOLOGY ASSIGNMENT
TITLE: PAROXYSMAL DISORDERS (SEIZURES )
SUBMITTED TO :DR.AYANA(PATHOLOGIST )
March 2023
FICHE
10/25/2023 Group 4 1

2. S.N Name ID
1 Tolesa Nigussie
2 Mulunesh Mosisa
3 Merga Wekwaya
4 Yadeta Kebede
5 Azazhu Abate
6 Geleto Hinika
7 Sufa Mengistu
8 Amansisa Dabasa
9 Worku Daba
Group members (G-4)
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Group 4

3. Course outlines
• Paroxysmal disorders
• Seizures vs. Epilepsy
• Type of Seizure
• Pathophysiology
• Clinical manifestation of seizures
• Complications of seizures
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4. Paroxysmal disorders:
• Paroxysmal; is derived from Greek word
paroxysmos or paroxyno meaning to sharpen
or irritate.
• Abrupt onset of a clinical episode that tends
to be stereotyped and repetitive , lasts
seconds or minutes (rarely hours ), and ends
abruptly.
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5. Types of Paroxysmal disorders
• Seizure
• Movement disorder
• Migraine
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6. Seizure :
• A seizure is “a brief, temporary disturbance in the
electrical activity of the brain” and may affect:
• Muscle control and movement
• Speech
• Vision and/or eye movement
• Awareness and/or behavior
• Seizures can be:
Convulsive or non-convulsive
Vary in frequency and severity
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7. Signs of a Seizure
• Extended blank stare
• "Empty" look in eyes
• Rapid blinking
• Eyes rolling upward
• Periods of
unresponsiveness
• Inability to pay attention
• Repetitive (tic-like)
movements of body
parts, usually head, arms,
legs
• Uncontrollable jerking
body movements
• Mouth movements with a
dazed look
• Frothing at mouth
• Loss of consciousness
• Loss of body control
• Dazed walking
• Temporary confusion
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8. Seizures vs. Epilepsy
• Seizures
• Often symptoms of
another health
problem: Provoking
factors : fever ,infection,
syncope, hypoxia,
toxins, head trauma,
stress,fatigue, cardiac
arrhythmias
• Epilepsy
• is the occurrence of two
or more unprovoked
seizures at an interval >
24 hours
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9. Types of Seizures
Focal (partial)
GENERALIZED
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10. Focal (partial)Type of Seizure
• Partial (Only a portion of the brain)(Focal Seizures) :
common, 80 % patients
• Simple partial(do not cause loss of consciousness)
o Simple with motor signs- convulsive jerking, chewing
motions, lip smacking
o Simple with sensory signs- Paresthesias, auras
o Autonomic: abdominal epilepsy
o Psychic :dejavu,fear,…
• Complex(Impaired consciousness)
psychomotor seizures or temporal lobe epilepsy or limbic
Aggressive behavior (Violence)
Visual, auditory, or olfactory hallucinations
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11. Generalized Seizures
• Absence Seizures (Petit mal)- alterations of
consciousness (absence) last10-30sec
• Tonic- sudden stiffness in the arms and body, which
can cause falls and injuries.
• Clonic- Sustained muscle contractions alternating with
relaxations
• Tonic/Clonic (Grand mal)-A sequence of a brief tonic
episode followed by an atonic seizure
• Atonic Seizures (Drop attacks)- sudden loss of body
tone that results in collapsing, often with injuries.
• Myoclonic Seizures: Sudden, involuntary jerking of
facial, limb or trunk muscles, in rhthmic manner.
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12. Etiology of seizures
• Perinatal conditions : CNS malformation,
hemorrhage, congenital infection, Brain injury to
fetus during pregnancy & birth
• Metabolic conditions:
hypoglycemia,hypocalcemia,B6 deficiency
hypomagnesemia, hypo or hypernatremia ,
storage disease, degenerative
• Poisoning :lead , cocaine, cyanide , co, pesticide,
strychnine
• drugs :
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13. Etiology of seizures Systemic
disorders :
• Neurocutaneous syndromes : Tuberous sclerosis,
Systemic disorders :
• Vasculitis ( CNS or systemic ); renal failure,
hepatic encephalopathy
• Infection: Meningitis: Viral encephalitis, Measles,
Mumps, Diphtheria
• Other : trauma , tumor, idiopathic , familial
Over-the-counter drugs, illicit substances herbal
preparations, can precipitate seizure
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14. Pathophysiology Seizure
• Paroxysmal discharges in cortical Neurons
• A seizure originates from grey matter of any cortical or
subcortical area
• Abnormal firing of neurons
• Breakdown of normal membrane conductance and
inhibitory synaptic currents
Locally widely
Focal Seizure Generalized seizure
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15. Focal Seizure Generalized seizure
 Abnormality of potassium
conductance
 Defect in voltage sensitive
ion channels
 Deficiency in membrane
ATPase
Neuron membrane instability
Seizures
 Deficiency of inhibitory
neurotransmitters
 Increase in excitatory
neurotransmitters
Promotes
Abnormal neuronal activity
Seizures
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16. Pathophysiology of Epilepsy
Cortical cell membrane level
Instability of the nerve cell membrane
Polarization abnormalities (excessive
polarization ,hypopolarization , or lapses in
repolarization), allowing the cell to be more
susceptible to activation Hypersensitive
neurons with lowered thresholds for firing and
firing excessively , related to
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17. Cont.…
1- Excess of Excaitatory ( acetylecholine- or
Glutamate –related activity )
2- Decreased inhibitory ( GABA –related
activity)Together leading to instability of cell-
membrane & lowered threshold for exciatation
excessive polarization, hypopolarization allowing
the cell to be more susceptible to activation
spontaneously or by any ionic imbalances in the
immediate chemical environment of neurons
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18. Complication:
• Hypoxemia and acidosis Hyperglycemia &
hypoglycemia
• Hyper tension & hypotension
• IICP and cerebral herniation
• Hyperpyrexia
• Hyperkalemia
• Myoglobinuria
• Non cardiogenic pulmonary edema
• Leukocytosis(60%)
• CSF pleocytosis(13%)
• Aspiration pneumonia
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19. References
1. Harvey S, King MD and Gorman KM(2021)
Paroxysmal Movement Disorders. Front. Neurol.
12:659064.doi: 10.3389/fneur.2021.659064.
2. https://images.app.goo.gl/bCYjzmZ6bVLcBZUN9
3. https://www.hopkinsmedicine.org/health/condi
tions-and-diseases/epilepsy/types-of-seizures.
4. https://images.app.goo.gl/rBcx4sSrUXKivKM28.
5. https://www.slideshare.net/SachinDwivedi15/se
izures-152346588
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20. Thank You!
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